Diagnostic moléculaire du Cytomégalovirus (CMV), de l’herpès virus humain de type 6 (HHV6) et d’Epstein-Barr virus (EBV) par PCR en temps réel chez les femmes enceintes VIH séropositives et séronégatives à Ouagadougou, Burkina Faso

Introduction: les herpès virus EBV, CMV et HHV-6 sont des virus qui évoluent sous le modèle pandémique et sont responsables d’infections congénitales pouvant provoquer des séquelles graves chez les nouveau-nés. L’objectif de cette étude était de déterminer les prévalences de CMV, EBV et HHV-6 chez les femmes enceintes VIH(+) et VIH(-) à Ouagadougou. Méthodes: dans cette étude 200 échantillons de plasma sanguin de femmes enceintes dont 100 femmes VIH(+) et 100 femmes VIH(-) ont été diagnostiqués par PCR multiplex en temps réel pour les trois infections (EBV, CMV et HHV-6). Résultats: sur l’ensemble des 200 échantillons analysés, 18 (9,0%) étaient positifs à au moins un des trois virus, 12 (6,0%) étaient positifs au EBV, 13 (6,5%) au CMV et 12 (6,0%) positifs au HHV-6. Parmi les 18 cas d’infections, nous avons trouvé 10 cas (55,6%) de coïnfections dont 90,0% (9/10) d’infection multiple EBV/CMV/HHV6 et 10,0% de coinfection EBV/HHV6. Le taux d’infection HHVs était plus élevé chez les femmes VIH(-) que celles VIH(+) (12,0% versus 6,0%). Parmi les VIH(+), la PCR a révélé 7,1% (soit 6/85) d’infection HHVs chez celles qui n’étaient pas sous ARV contre 0% chez celles sous ARV. Conclusion: les herpès virus sont fréquents chez les femmes enceintes au Burkina Faso et pourraient constituer une menace chez ces dernières à cause des complications et des risques d’infection pour le nouveau-né.The Pan African Medical Journal 2016;2

Hepatitis B, C, and D virus and human T-cell leukemia virus types 1 and 2 infections and correlates among men who have sex with men in Ouagadougou, Burkina Faso

Abstract Background Men who have sex with men (MSM) are considered to be at significant risk for sexually transmitted infections (STI) and bloodborne viruses including viral hepatitis types B, C, and D (HBV, HCV, and HDV) and human T-cell leukemia virus types 1 and 2 (HTLV 1&2). This study aimed to assess the seroprevalence and correlates of HBV, HCV, HDV, and HTLV 1&2 antibodies among MSM in Ouagadougou, Burkina Faso. Methods We conducted a cross-sectional survey to assess the biological and behavourial characteristics among MSM in Ouagadougou from January to April 2013. Serum specimens obtained were tested for the presence of HBV, HCV, HDV and HTLV-1&2 infections. MSM 18 years and older were recruited using respondent driven sampling (RDS). Population estimates and 95% confidence intervals (CI) adjusted for the RDS design were calculated using RDS Analysis Tool (RDSAT) version 6.0.1 (RDS, Inc., Ithaca, NY). Bivariate and multivariate logistic regression analyses were conducted to assess correlates of these infections using Stata 14. Results A total of 329 MSM were tested. Prevalence was 20.4% (95% CI: 16.4–25.1) for HBV, 11.0% (95% CI: 8.0–14.8) for HCV, and 0.0% for HDV. Anti-HTLV 1&2 antibodies were found in 4.0% (95% CI: 2.3–6.8) of MSM. Factors independently associated with HBV infection were lack of condom use during the last anal sex act with a main male sexual partner and experience of condom tearing during anal sex. Presence of anti-HTLV 1&2 antibodies was associated with history of genital or anal lesions and injection drug use. None of the variables included in our study were associated with HCV. Conclusions This study shows that HBV, HCV and HTLV 1&2 prevalence among MSM in Burkina is high and suggests that comprehensive STI prevention and sexual health education services for this group are needed

Résistance aux antibiotiques des souches de staphylococcus aureus et des enterobactéries isolés au LNSP de Ouagadougou (Burkina Faso)

Le contexte africain est marqué par l’absence de réseau de surveillance de la résistance bactérienne aux antibiotiques. Des études indiquent pourtant des niveaux élevés de prévalence de Staphylococcus aureus résistant à la méticiline (SARM) et des Entérobactéries productrices de β lactamases à spectre étendu (E-BLSE) dans les prélèvements provenant de patients hospitalisés ou en communauté. Le but de la présente étude est de décrire les phénotypes de résistances de Staphyloccocus aureus et des entérobactéries afin d’améliorer la prise en charge des maladies bactériennes. Il s’est agi d’une étude transversale réalisée du 10 Septembre 2014 au 10 Mars 2015, à partir des isolats de S. aureus et d’entérobactéries provenant de prélèvements biologiques reçus au Laboratoire National de Santé Publique (LNSP). La sensibilité aux antibiotiques des souches bactériennes a été réalisée selon les recommandations du Comité de l’Antibiogramme de la Société Française de Microbiologie (CA.SFM) 2014. La recherche de la résistance de S. aureus à la meticilline a été réalisée par l’oxacilline 5μg ; la sécrétion de β Lactamase à Spectre Elargie (BLSE) a été confirmée après observation d’une image en « bouchon de champagne ». Au total, 665 échantillons ont été traités et 197 souches pathogènes, ont été identifiées dont 160 entérobactéries et 37 Staphylococcus aureus. Globalement, 32 % des Staphylococcus aureus étaient résistants à la méticiline. Toutes les souches étaient sensibles aux aminosides. Parmi les entérobactéries, 98,3 % des E. coli et 94,7 % de K. pneumoniae étaient résistantes à l’amoxicilline + acide clavulanique et 36,4 % de E. coli et 26,3 % K. pneumoniae présentaient une résistance aux céphalosporines de 3e génération. Les entérobactéries productrices de BLSE étaient de 35 %. L’imipenème restait actif sur 100 % des entérobactéries. Cette étude interpelle les autorités sanitaires à l’instauration d’un système de surveillance des pharmaco résistances et les agents de santé sur la promotion du bon usage des antibiotiques et les bonnes pratiques d’hygiène hospitalière.Mots-clés: Entérobactéries, Staphylococcus aureus, antibiotiques, sensibilité, résistanceEnglish Title: Antibiotic resistance of staphylococcus aureus strains and insulated enterobacteries at the Ouagadougou LNSP (Burkina Faso)English AbstractThe African context is marked by the absence of a surveillance network for bacterial resistance to antibiotics. However, studies indicate high levels of methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum β-lactamase-producing Enterobacteriaceae (E-ESBLs) in inpatient and community samples. The aim of this study was to describe the resistance phenotypes of S. aureus and enterobacteria in order to improve bacterial diseases management. This was a cross-sectional study conducted from September 10, 2014 to March 10, 2015, on isolates of S. aureus and enterobacteria from biological samples sent to the National Laboratory of Public Health (LNSP). The antibiotic susceptibility of bacterial strains was carried out according to the recommendations of the Antibiogram Committee of the French Society of Microbiology (CA.SFM) 2014. The search for S. aureus resistance to meticillin was carried out by the oxacillin 5μg; the secretion of ESBL was retained after observation of a "champagne cork" image. A total of 665 samples were processed and 197 pathogenic strains were identified, including 160 Enterobacteriaceae and 37 Staphylococcus aureus. Overall 32% of Staphylococcus aureus were meticillin resistant. All strains were susceptible to aminoglycosides. Among the Enterobacteriaceae, 98.3% of E. coli and 94.7% of K. pneumoniae were resistant to clavulanic acid amoxicillin and 36.4% of E. coli and 26.3% K. pneumoniae were resistant to 3rd generation cephalosporins. ESBL-producing enterobacteria were 35%. Imipenem remained active on 100% of Enterobacteriaceae. This study calls on the health authorities to establish a surveillance system for drug resistance and health workers to promote the proper use of antibiotics and good hospital hygiene practices.Keywords: Enterobacteriaceae, Staphylococcus aureus, antibiotics, sensitivity, resistanc

Bio-behavioural HIV survey in prisons on men and women in Burkina Faso.

BackgroundDespite the severity of the human immunodeficiency virus (HIV) epidemic in Burkina Faso, data on specific groups are scant especially concerning prisoners. AimsThe objective of this study was to determine HIV prevalence and risky behavior in Burkina Faso prisons in order to assist in HIV prevention and AIDS case management decision making among prisoners. Methods This was a cross-sectional study carried out from September 3–10, 2014 among 18 years aged and over prisoners, in prisons of each of the 13 administrative regions of Burkina Faso with prisoners’ informed consent. Data were collected using a questionnaire that covered general informations on HIV/autoimmune insufficiency syndrome (AIDS) and sexually transmitted infections (STIs), coupled with blood samples collection, for HIV laboratory analysis purpose.Results A total of 1,079 prisoners participated in this study. The participation rate for interviews was and blood samples collections were 100 per cent. The majority of participants (97.8 per cent) were men, among whom 9.7 per cent reported a history of STIs. Nearly 50 per cent of these took no precautions to avoid infecting their sexual partners. Implementation of HIV/AIDS prevention and control activities in prisons was low (43.2 per cent). Condom use was also low (11.2 per cent). HIV infection Screening was insufficient: only two out of five prisoners had at least one HIV screening. HIV screening opportunities was uncommon and prisoners pointed out the lack of organization of screening campaigns in prisons. HIV prevalence was nearly 3 per cent. ConclusionThe exposure level of prisoners to HIV transmission prevention interventions was low. Specific measures are needed to increase condom use for HIV/AIDS and STIs prevention in prisons

Profil de sensibilité des souches de pneumocoques aux antibiotiques avant l’introduction du vaccin anti pneumococcique conjugué à treize valences (PCV-13) au Burkina Faso

Introduction: Streptococcus pneumoniae constitue un pathogène important des méningites bactériennes aiguës au Burkina Faso. Cela a justifié l’introduction du vaccin pneumococcique conjugué en Octobre 2013 dans le programme élargi de vaccination chez les enfants de moins d’un an. L’objectif de ce travail consiste à établir le profil de sensibilité aux antibiotiques des souches de S. pneumoniae isolées du liquide cérébro-spinal. Méthodologie: Du 1er Janvier 2010 au 30 Décembre 2012, 37 souches de pneumocoques ont été collectées du réseau national de surveillance de la méningite du pays. Ces souches, repiquées sur de la gélose au sang frais, ont été confirmées par le test de sensibilité à l’optochine. Le test de Quellung a déterminé les sérotypes de pneumocoques et l’antibiogramme a été réalisé selon la méthode de diffusion et interprété selon le standard « European Committee of antibiotics susceptibility testing. Résultats: Sur 37 isolats sérotypés, 77% appartenaient aux sérotypes vaccinaux. L’antibiogramme a révélé que 92% des souches sensibles à l’oxacilline, 97% à l’érythromycine et 73% à la clindamycine. Le cotrimoxazole a été actif dans 14% et la tétracycline seulement 5% des souches. Conclusion: La majorité des souches de pneumocoques isolée des méningites au Burkina Faso appartiennent aux sérotypes vaccinaux. Mots clés: Sensibilité; Antibiotiques; Pneumocoques; PCV-13 English Title: Profile of antibiotics susceptibility testing of pneumococcal strains before the introduction of the thirteen-valent conjugate pneumococcal vaccine (PCV-13) in Burkina Faso English Abstract  Introduction: Streptococcus pneumoniae is an important pathogen of acute bacterial meningitis in Burkina Faso. This justify the introduction of the thirteen-valent pneumococcal vaccine in October 2013 in the expanded program of immunization in children under one year old. The aim of this work is to establish the antibiotics susceptibility testing profile of strains of S. pneumoniae isolated from cerebrospinal fluid. Methods: From January 1st, 2010 to December 30th, 2012, 37 strains of pneumococci were collected from the country's national meningitis surveillance network. These strains, subcultured on fresh blood agar, were confirmed by the optochin susceptibility testing. The Quellung test made it possible by determining the pneumococcal serotypes and the antibiogram carried out according to the diffusion method and interpreted according to the standard "European Committee of antibiotics susceptibility testing”. Results: Of the thirty-seven typed isolates, 77% belonged to the vaccine serotypes. Susceptibility to antibiotics reports 92% of strains susceptible to oxacillin, 97% to erythromycin and 73% to clindamycin. Cotrimoxazole was active in 14% and tetracycline only 5% of the strains. Conclusion: The majority of pneumococcal strains isolated from meningitis in Burkina Faso belong to vaccine serotypes. Keywords: Antibiotics; susceptibility testing; Pneumococci; PCV-1

Changes in body mass index and hemoglobin concentration in breastfeeding women living with HIV with a CD4 count over 350: Results from 4 African countries (The ANRS 12174 trial)

Introduction: Breastfeeding is recommended for infants born to HIV-infected women in low-income settings. Both breastfeeding and HIV-infection are energy demanding. Our objective was to explore how exclusive and predominant breastfeeding changes body mass index (BMI) among breastfeeding HIV1-positive women participating in the ANRS12174 trial (clinical trial no NCT0064026). Methods: HIV-positive women (n = 1 267) with CD4 count >350, intending to breastfeed HIV-negative infants were enrolled from Burkina Faso, South Africa, Uganda and Zambia and counselled on breastfeeding. N = 1 216 were included in the analysis. The trial compared Lamivudine and Lopinavir/Ritonavir as a peri-exposure prophylaxis. We ran a linear mixed-effect model with BMI as the dependent variable and exclusive or predominant breastfeeding duration as the key explanatory variable. Results: Any breastfeeding or exclusive/predominant) breastfeeding was initiated by 99.6% and 98.6% of the mothers respectively in the first week after birth. The median (interquartile range: IQR) duration of the group that did any breastfeeding or the group that did exclusive /predominant breastfeeding were 9.5 (7.5; 10.6) and 5.8 (5.6; 5.9)) months, respectively. The median (IQR) age, BMI, CD4 count, and HIV viral load at baseline (day 7) were 27 (23.3; 31) years, 23.7 (21.3; 27.0) kg/m2, 530 (432.5; 668.5) cells/μl and 0.1 (0.8; 13.7)1000 copies/mL, respectively. No major change in mean BMI was seen in this cohort over a 50-week period during lactation. The mean change between 26 and 50 weeks after birth was 0.7 kg/m2. Baseline mean BMI (measured on day 7 postpartum) and CD4 count were positively associated with maternal BMI change, with a mean increase of 1.0 kg/m2 (0.9; 1.0) per each additional baseline-BMI kilogram and 0.3 kg/m2 (0.2; 0.5) for each additional CD4 cell/μl, respectively. Conclusion: Breastfeeding was not negatively correlated with the BMI of HIV-1 infected Sub-Saharan African mothers. However, a higher baseline BMI and a CD4 count >500 cells/μl were associated with maternal BMI during the exclusive/ predominant breastfeeding period. Considering the benefits of breast milk for the infants and the recurrent results from different studies that breastfeeding is not harmful to the HIV-1-infected mothers, this study also supports the WHO 2016 guidelines on infant feeding that mothers living with HIV should breastfeed where formula is not safe for at least 12 months and up to 24 months, given that the right treatment or prophylaxis for the infection is administered. These findings and conclusions cannot be extrapolated to women who are immune-compromised or have AIDS

Characteristics of HIV-2 and HIV-1/HIV-2 Dually Seropositive Adults in West Africa Presenting for Care and Antiretroviral Therapy: The IeDEA-West Africa HIV-2 Cohort Study.

HIV-2 is endemic in West Africa. There is a lack of evidence-based guidelines on the diagnosis, management and antiretroviral therapy (ART) for HIV-2 or HIV-1/HIV-2 dual infections. Because of these issues, we designed a West African collaborative cohort for HIV-2 infection within the framework of the International epidemiological Databases to Evaluate AIDS (IeDEA).We collected data on all HIV-2 and HIV-1/HIV-2 dually seropositive patients (both ARV-naive and starting ART) and followed-up in clinical centres in the IeDEA-WA network including a total of 13 clinics in five countries: Benin, Burkina-Faso Côte d'Ivoire, Mali, and Senegal, in the West Africa region.Data was merged for 1,754 patients (56% female), including 1,021 HIV-2 infected patients (551 on ART) and 733 dually seropositive for both HIV-1 and HIV 2 (463 on ART). At ART initiation, the median age of HIV-2 patients was 45.3 years, IQR: (38.3-51.7) and 42.4 years, IQR (37.0-47.3) for dually seropositive patients (p = 0.048). Overall, 16.7% of HIV-2 patients on ART had an advanced clinical stage (WHO IV or CDC-C). The median CD4 count at the ART initiation is 166 cells/mm(3), IQR (83-247) among HIV-2 infected patients and 146 cells/mm(3), IQR (55-249) among dually seropositive patients. Overall, in ART-treated patients, the CD4 count increased 126 cells/mm(3) after 24 months on ART for HIV-2 patients and 169 cells/mm(3) for dually seropositive patients. Of 551 HIV-2 patients on ART, 5.8% died and 10.2% were lost to follow-up during the median time on ART of 2.4 years, IQR (0.7-4.3).This large multi-country study of HIV-2 and HIV-1/HIV-2 dual infection in West Africa suggests that routine clinical care is less than optimal and that management and treatment of HIV-2 could be further informed by ongoing studies and randomized clinical trials in this population